| Objective:The immune reconstructive effect and viral load suppression of 271 AIDS patients who received antiviral therapy for the first time in Yan’an Second People’s Hospital were analyzed.To explore the influencing factors of immune reconstitution and viral load suppression in patients;To explore the correlation between CD4~+T lymphocyte count and viral load in patients 1 year after antiviral therapy(12±1 month).Method:In the AIDS prevention and treatment information system,the general information of patients receiving antiviral treatment in Yan’an Second People’s Hospital and the data after 1 year of treatment were downloaded,and the data of patients receiving antiviral treatment for the first time between January 1,2018 and May 31,2021 were screened.The differences of CD4~+T lymphocyte count and viral load between patients before HAART and 1 year after HAART were explored to determine the status of immune reconstitution,and the factors affecting the number of CD4~+T lymphocytes and viral load were analyzed.The logarithmic conversion of viral load higher than the lower limit of detection after treatment and the correlation analysis of the number of CD4~+T lymphocytes after treatment;Results:The median number of CD4~+T lymphocytes in 271 patients was 289(178,438)/mm~3 before antiviral treatment,435(337,643)/mm~3,higher than before treatment(Z=-11.899,P<0.01).The median increase in CD4~+T lymphocyte count was 153(68,243)cells/mm~3.Analysis of the correlation between the number of CD4~+T lymphocytes at different baseline and the increase in the number of CD4~+T lymphocytes 1 year after antiviral treatment showed an overall negative correlation,that is,the increase in the number of CD4 cells in patients with lower baseline CD4 cells was higher than that in patients with higher baseline CD4 cells.There was statistical significance in the increase of CD4~+T lymphocytes≥100/mm3 at different age of initial treatment,baseline CD4~+T lymphocytes and baseline WHO clinical stage(P<0.05).After 1 year of antiviral treatment,27 patients had viral load≥400 copies/m L,accounting for 10.0%;The viral load of 244 patients was less than 400 copies/m L,accounting for 90.0%,and the viral load of 239 patients was lower than the detection limit,accounting for 88.2%.Multivariate Logistic regression analysis of baseline data and viral load data 1 year after antiretroviral therapy showed that stageⅡwas a protective factor for viral suppression failure compared with stageⅠ,and stageⅢandⅣwere a risk factor for viral inhibition failure compared with stageⅠ.Drug omission(OR=8.961,95%CI=1.987-40.417)was a risk factor for viral inhibition failure compared with no drug omission(P<0.05).After 1 year of treatment,the total number of CD4~+T lymphocytes was negatively correlated with viral load(r=-0.398,P<0.05),but there was no statistical significance between different CD4~+T lymphocytes and viral load(P>0.05).Conclusion:1.AIDS patients recover significantly after 1 year of HAART treatment;Immunological recovery was better in younger patients receiving antiviral therapy than in older groups;The lower the baseline CD4 cell number level,the higher the success rate of immunological therapy;Patients with earlier WHO clinical staging have better immunological outcomes after receiving antiviral therapy;2.Viral load suppression was significant after one year of HAART,and WHO clinical stage II.relative to phase I was a protective factor for viral suppression failure,and stage III.and IV.were risk factors for viral suppression failure.Missed medication is a risk factor for viral suppression failure compared with no missed medication.3.After 1 year of antiviral treatment,the number of CD4 cell was negatively correlated with the viral load detection value,the viral load pair value decreased with the increase of CD4 cell count after 1 year of antiviral treatment. |
PDF Full Text Request